This month’s key notes...

The NPA has developed a Flu and other Vaccination Services Implementation Guide that can be used by pharmacy owners and staff. This resource will provide pharmacies with a comprehensive plan to prepare the whole pharmacy business and staff for the 2022-2023 flu season.

Due to the Covid-19 pandemic, there have been many changes to the way in which a pharmacy operates in order to maintain good infection control to ensure safety for staff and customers. This guide will address additional factors that may need to be considered when implementing a flu or other vaccination service in the pharmacy. To download go to www.npa.co.uk/flu-guide

Accessing printed versions of the BNF and BNF for children

The National Institute for Health and Care Excellence (NICE) has stopped distributing printed copies of the British National Formulary (BNF) and the BNF for Children (BNFC) to all community pharmacy contractors since September 2022. Pharmacy contractors are encouraged to access the digital resource as this provides the most up-to-date information.

The digital versions can be accessed here: www. bnf.nice.org.ukThe Pharmaceutical Press and its publishing partners recognise that many healthcare professionals prefer accessing content via printed copies over digital format, so if your pharmacy would like access to a print copy, contact the Pharmaceutical Press. Details can be found on its website at www.pharmpress.com

Newly qualified pharmacist pathway

This year’s Newly Qualified Pharmacist pathway is now open for registrations. It is designed for learners across all sectors of pharmacy, to help them meet their development needs as they enter practice. The pathway aims to link the initial education and training reforms to a continuum of post-registration development. It is intended to help pharmacists make the transition to more independent learning and acts as a stepping-stone towards enhanced and advanced practice. You can learn more about the pathway at bit.ly/3LbtY0j

ALSO THIS MONTH

Ask Your Pharmacist Week 2022

The next ‘Ask Your Pharmacist’ Week will run from 31 October to 7 November, the NPA has announced. AYP Week, held every year across the UK, aims both to raise awareness of pharmacy services and to prompt conversations with key stakeholders at a local level about community pharmacy’s role and benefits. Activities in previous years have ranged from public exhibitions and window posters to social media campaigns, projects with patient groups and visits to pharmacies from local politicians.Any NPA member or pharmacy stakeholder wishing to get involved should contact the NPA’s Head of Communications, Stephen Fishwick, at: s.fishwick@npa.co.uk

NPA’s weight management hub

The NPA and Novo Nordisk are working collaboratively to support independent community pharmacies in delivering services to assist their patients with weight management and obesity.

A weight management hub contains the information, training materials and support you will need to set up up weight management and obesity services in your pharmacy. For more information, visit the NPA’s ‘Getting started’ page and the ‘Setting up your service’ page which gives you all the necessary steps to consider when setting up your service. If you do set up a weight management service you will receive further support from a business development manager at Novo Nordisk.For further details go to: bit.ly/3O0exbi

Scotland’s Public Health Minister proud of pharmacy colleagues

Public Health Minister for Scotland Maree Todd, who was the chief guest at an NPA event on Sunday 4 September, said she was “incredibly proud” of what her pharmacy colleagues have overcome over the last two and half years.

Some 50 guests joined the minister for a dinner at Balmoral Hotel in Edinburgh, organised as part of the NPA’s 100 year anniversary celebrations. Maree, a former hospital pharmacist, told guests that community pharmacy teams in Scotland are at “the heart of our communities and have been pivotal in our response to the pandemic in ensuring that local communities had access to vital medicines and the full range of pharmaceutical care services, which hadn’t come without its difficulties”.

“It makes me incredibly proud to say that I am a pharmacist when I see how my profession and the wider pharmacy team have taken on, and overcome, the many challenges of the last two and half years,” she said. “I would like to say a wholehearted thanks for the vigilance and resilience you’ve shown in the face of an ever-changing environment. I’m sure that everyone across Scotland has recognised that community pharmacy teams are a vital part of the NHS.”

The minster also recognised workforce pressures in the sector and the need to identify practical solutions. “The chief pharmaceutical officer has established a Pharmacy Workforce Forum to provide strategic influence and nationally co-ordinated actions to support short, medium and long term evidence-based pharmacy workforce planning – including for new emerging roles.

"Alongside ensuring that a workforce with the right skills and competencies is deployed in the appropriate settings, the Forum will consider the interconnected nature of the sectors with associated service redesign and transformation, and the use of technology and artificial intelligence.”

Harry McQuillan, chief executive at Community Pharmacy Scotland, thanked the Scottish Government team for its support. “Community Pharmacy Scotland was in daily contact with the team, sharing information, network concerns and providing solutions throughout this time,” he said.

Alison Strath, chief pharmaceutical officer for Scotland, who also attended the event, said: “My team and I have already escalated some of the pressures you are currently experiencing in terms of the impact of the cost of living crisis and also other increasing business operating costs, and we will work with Community Pharmacy Scotland to consider how we best mitigate them.

“Despite these challenges, it is important that we don’t lose sight of our ambitions. There is real desire from government to further develop the services offered by community pharmacy. Having once worked for the NPA I have always been struck by how the Association, right across its 100-year history, has its members at the heart of what it does."

NPA roundtable with patient groups

The NPA is holding a roundtable discussion with patient groups in October.Patients will share their experiences of existing pharmacy services and discuss their future development. How have expectations changed as a result of the covid pandemic?

What do patients value most and what would make it easier for them to access primary care and preventative interventions? How is tech changing the formula of what excellent care looks like, from the patient point of view? Finally, are there any limits, in principle, to the expansion of community pharmacy clinical roles within the NHS, from the user perspective? Watch out for a report of the event in the next edition of NPA essential.

Upgrade to the latest Pro Delivery Manager

The creator of a leading delivery tracking app for pharmacies says many contractors are still using an older version of the software. Pro Delivery Manager (PDM) enables pharmacies to improve the efficiency of their local delivery service by monitoring deliveries from start to finish and providing an audit trail for the pharmacy team.

The latest version of the app was introduced in 2020 with 148 upgrades to make it a more rounded user experience for pharmacy teams. The main difference is that PDM can now track tasks inside the pharmacy and not just deliveries, putting the patient at the heart of the system.

NPA member and PDM creator, Gary Jones, owner of an independent pharmacy in Aberystwyth, said: “We’ve had the latest version since 2020 but most people are still on the older iteration. Previously users were asking for more flexibility in the product. The main feature in the new PDM is a multiple task system enabling the pharmacy to not only schedule deliveries but also collections and other tasks that need to be carried out in the pharmacy. We have ensured the layout is similar to the previous version to make it a seamless experience for users.”

He added: “The latest version of PDM allows users to integrate with their patient medication record (PMR) systems - EMIS, Cegedim, Positive Solutions and RxWeb are currently available, with TitanPMR in the final stages of being set up. All of these integrated solutions provide a better user experience and ensure that patient data is captured accurately.”

Another key feature that has been introduced is third party access to the app. Care organisations, for example, can be notified by email or text regarding a client’s delivery but can also be permitted (via a limited account access) to see all pending and completed deliveries.

“Pharmacies can get lots of phone calls from care homes or care organisations to see if the patient medication has been delivered to the patient,” explained Gary. “This new feature is not only a time saver for both the pharmacy and the care organisation but an excellent way of promoting a new service.”

Over 1,500 pharmacies use PDM in the UK and 1.5 million deliveries are made using the app every year, but there are also pharmacies in the USA and Australia that use the software. NPA member pharmacy Pearl Chemists in Tooting, London, has been running a delivery service for more than 15 years.

Eight drivers support their 23 sites to make more than 300 daily deliveries. With increasing pressure on business margins, plus greater GPhC focus on clear audit trails and patient data safety, pharmacy director Mike Patel was looking for a more robust way to manage the service.

He said: “Home delivery is a free service for our customers, but is a cost to the business. I am keen to make our deliveries as efficient and cost effective as possible.”

Learning about PDM from the NPA, Mike was persuaded to take up a free trial and, within 14 deliveries, was convinced of the benefits.

“Our delivery success rate is now over 93 per cent, and the data provided by the system is outstanding. My drivers are taking the most efficient route, which is cutting fuel costs, and now we don’t spend lots of time managing heaps of paper.”NPA members receive £10 off their monthly PDM bill compared with the standard price. To find out more, visit www.npa.co.uk/business-support/pdm

Clarification and update on CD prescriptions’ appropriate dates and validity

Following a number of NPA member queries regarding the dispensing Controlled Drug (CD) prescriptions legally in relation to their appropriate date and validity, especially for days when the pharmacy may be closed over weekends and bank holidays, here are some key points to take into consideration:

Key points

• The item (in the case of instalment prescriptions for CDs, this would be the first instalment) must be supplied within 28 days of the appropriate date on the prescription, as stated in The Misuse of Drugs (Amendment No. 2) Regulations 2006. For instalment prescriptions, the remainder of the instalments are required to be dispensed in accordance with the prescriber’s instructions.

• The appropriate date is the later of the dates on which the prescription was signed (issue date) or the date indicated on the prescription as to when it should be dispensed, as stated in the Human Medicines Regulations 2012.

• The presence of the Home Office approved wording “Please dispense instalments due on pharmacy closed days on a prior suitable day” allows instalments due on a day when the pharmacy is closed to be dispensed in advance.

• The pharmacist can exercise professional judgement on the appropriate supply date if the issue date on the prescription is before the treatment start date and the prescriber has included the appropriate HO wording (refer to example below):

• If a pharmacist decides to supply against a prescription that uses unapproved wording, the HO will not safeguard the pharmacist from legal ramifications when making the supply. The pharmacist should attempt to get the prescription amended so that it carries the HO approved wording.

• When presented with an instalment prescription with this wording, it may be advisable to clarify with the prescriber, and document details of the discussion where necessary, when the instalment is to be dispensed on a day other than the day immediately prior to closure to ensure that patient care is not compromised.

• Read the full information in the DHSC treatment guidelines, Drug misuse and dependent: UK guidelines on clinical management. The criteria that a prescription must satisfy can be found on p279: www.gov.uk/government/publications/drug-misuse-and-dependence-uk-guidelines-on-clinical-management

• A pragmatic approach can support patient care and prevent unnecessary disruption to treatment.

• All actions taken should be clearly documented, including the decision on whether a supply is made. This will help the pharmacist demonstrate any actions taken were in the patient’s best interest.

For further details go to bit.ly/3ROB0KK

Health Education England - Remote Consultations elearning programme now available

Health Education England elearning for healthcare (HEE elfh) has developed an elearning programme on remote consultations as part of a wider training recovery programme.The resource consists of practical tips for educators and learners in medical and allied healthcare professions, and aims to provide a generic ‘one-stop’ practical guide on remote consultations.

The session is designed to complement existing specialty and profession specific resources available from HEE elfh and other education platforms. Remote Consultations highlights the process of setting up a remote consultation clinic and the pitfalls of this environment, with specific emphasis on appropriate patient selection, plus the benefits and limitations of remote consultations.

On completion of the programme learners will achieve several skills including:

• Describing the benefits and limitations of a remote consultation

• Describing requirements needed and discussing patient selection

• Describing measures in ensuring patient remote consultation. A suite of resources for trainers and trainees is also available for learners to access, including relevant links to websites, videos and papers.

For more information and to access the programme, visit bit.ly/3BhqJQb

Protecting pharmacy staff from sexual harassment - Employers’ duties

As a society, we’re becoming increasingly vocal about instances of sexual harassment in all areas of life – whether it be unwelcome touching at a social event or sexual remarks made by colleagues.It is important that pharmacy employers take a firm stance against any behaviour that oversteps the mark, and understand how to prevent and respond to any such incidents in the workplace.

Here is some advice on frequently asked questions from employment law experts Worknest...

What constitutes sexual harassment?

Sexual harassment takes many forms – some more blatant than others. While it typically involves a pattern of repeated, persistent behaviour, one-off occurrences can amount to sexual harassment too. As well as unwanted physical contact, sexual harassment may include:

• Sexual “banter” or jokes about a colleague’s sex life

• Asking intrusive sexual questions

• Spreading sexual rumours

• Making sexually offensive or suggestive gestures or facial expressions

• Repeatedly asking a colleague out on a date or for sexual favours

• Sharing inappropriate stories about sexual experiences

• Following a colleague around or paying them excessive attention

• Staring or leering

• Sending emails of a sexual nature or sharing/displaying sexually explicit images; and

• Making insulting comments about someone’s gender identity or sexual orientation (or asking about someone’s sexual orientation).

It’s important to note that this isn’t an exhaustive list. Under Section 26(4) of the Equality Act 2010, sexual harassment is any unwanted conduct of a sexual nature which has the purpose or effect of violating someone’s dignity, or creating an intimidating, hostile, degrading, humiliating or offensive environment for them.

The “purpose or effect” wording essentially means that it isn’t just the perpetrator’s intentions that matter when determining whether or not an act constitutes sexual harassment but also how the act was perceived by the person affected.

What does the law expect of employers?

As it stands, responsibility for reporting sexual harassment at work lies with the victim, and employers are currently under no legal obligation to prevent it from happening through any proactive means. However, an alliance of unions, charities and women’s rights groups have, in recent years, pushed for legislation that would close this gap in the law.

The alliance, which goes by the name This Is Not Working, has launched a petition that seeks to shift the responsibility onto employers, calling for clearer policies and mandatory training for staff and managers.In fact, in January 2020, the Equality and Human Rights Commission (EHRC) released technical guidance to help employers tackle and respond effectively to harassment. “No workplace is immune to harassment, and a lack of reported cases does not mean that people have not experienced it”, it said.

The EHRC’s recommendations for organisations include:

•Developing an effective anti-harassment policy – including a statement in relation to conduct outside of the workplace and information regarding third-party harassment – and ensuring this is communicated effectively.

•Engaging staff to ensure they have ample opportunity to raise concerns in an informal manner, and ensuring managers proactively look for signs of harassment.

•Identifying risk factors relating to harassment and victimisation and implementing control measures to minimise these risks.

•Introducing an online or externally-run telephone reporting systemto allow workers to make anonymous complaints, similar to a whistleblowing hotline, to highlight problems that may otherwise go undetected.

•Providing training for all staff on what they should do if they experience or witness harassment; for managers on how to deal with complaints; and for harassment “champions” or ambassadors on how to support someone through the complaints procedure. To read the rest of this article go to: bit.ly/3QBy4jm

The all too real threat of cyber-crime

The cost of living crisis is having a direct and detrimental impact on businesses up and down the country. It is therefore understandable that community pharmacy is looking to manage costs wherever possible. Yet now, more than ever, pharmacies must ensure that they have taken adequate measures to protect their business and their livelihood against emergent risks associated with today’s challenging economic climate.

Whilst members are aware of the need to ensure that they have adequate personal indemnity, property and general insurance cover to protect their business, the urgent need for protection against cyber-crime is still neither fully recognised nor understood, and consequently not perceived as an insurable risk.

Yet cyber-attacks can have a huge and damaging effect on all areas of the business, from loss of revenue and inability to access online systems to handling customer complaints and running the day to day business. These threats will only become more prevalent as community pharmacy takes on a more diverse role within the provision of primary healthcare and the growth of e-pharmacy.

Daryn Hughes, claims manager at NPA Insurance, comments: “In my experience, policy holders do not fully appreciate the very real threat they face from cyber-attack. For pharmacy, this might be partly because security linked to NHS sites is perceived to be adequate.

"All too often it is not until a business has been compromised in this way that the need for cover is recognised. And then it is too late.”

The cyber-attack on the NHS 111 service in August caused a major software outage which impacted the service for days and put huge pressure on A&E services up and down the country. It brought home the very real threat of cyber-crime to the NHS and its partners such as community pharmacy.

Sadly, NPA Insurance has witnessed members falling foul of cyber-crime and suffering the consequences. Business development manager, Julie Dawson, shares this example: “We recently received a call from one of our members who had clicked on a link in an email supposedly sent from the NHS. Unfortunately it was a phishing scam and the pharmacy in question had significant funds redirected.

“Our Pharmacover policy provides a level of protection against staff dishonesty for our members, if the relevant add-on is chosen, but as this was an external breach the pharmacy was not covered for the loss. As well as the money stolen from their bank account, this attack cost our member in other ways, including the significant time, resource and stress involved in dealing with the devastating aftermath of the incident.”

NPA Insurance offers cyber cover to its members through insurer partners to provide protection against a variety of threats, from viruses and ransomware to cyber-attack and associated breaches of privacy.

Julie explains: “Equally importantly, members have direct access to a round-the-clock help line in the event of an incident. So if they do fall victim to cyber-crime and their systems are compromised, they will be able to speak to experts who will advise them on how to deal with the breach and get up and running again as quickly as possible, as well as investigate what data has been compromised. The cover also provides access to PR professionals who will advise on how to mitigate reputational damage.”

Cyber-crime might seem like a distant threat to community pharmacy, but NPA Insurance’s advice is to ignore it at your peril. To find out more about the cyber cover available to our members contact Julie Dawson on 07946 518855 or email j.dawson@npa.co.uk